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Chapter 8 Control and managementsduring the healing periodAn adequate unloading period and a thorough avoidance of thefunctional loadings are absolute requirements for the implants placedinto the bone to achieve osseointegration. For about 2 weeks after thesurgery, as mentioned previously, the use of the denture that has beenused, should be minimized to prevent applying loads. The unloadingperiod of Platon implants is three months for the mandible andsix months for the maxilla. However, a longer healing period maybe required based on the health of the individual bone. Because theprolonged healing period allows for achieving secured osseointegration,the inferior bone quality can be overcome. In addition, infectionprevention should be carefully considered. The removal of the sutureis commonly done seven to eight days after the surgery. However, theremoval of the suture should be done carefully so that the contaminatedsuture thread does not pass through the tissue during removal.Estimated unloading periodMaxilla: 6 monthsMandible: 3 monthsManagements during the healing period• Avoidance of functional loadings on the site where an implantwas placed ・・・ frequent adjustments of the temporary restorationand guidance• Infection prevention ・・・ regular examination and cleaning,disinfection, plaque control, and hygienic guidance• Maintenance of occlusal relationship ・・・ adjustments ofthe temporary restoration (prevention of extrusion or displacement).Control and managements during the healing period1) Submerged protocolThe submerged protocol also has the same basic technical cautionsas the nonsubmerged protocol. However, when the implant head completelylocated in the submucosa exposes from the mucosa, cleaningand disinfection should be repeated in order to keep thorough sanitaryconditions as it is rather than trying to re-suture too hard.Nonsubmerged protocolSubmerged protocolChapter 82) Verification of osseointegrationOsseointegration should be achieved within a specified period asmentioned previously. However, it is difficult to accurately determineosseointegration. The assessments of the achievement and healingperiod of osseointegration are made on the basis of the following factors:patient’s age, general conditions, and bone quality as factors onthe host side, cutting resistance against drilling during the placementsurgery, the extent of primary stabilization of the implant, and percussionsound as operator’s experiment factors, and objective assessmentcriteria, such as Periotest® and Osstell®.43 SURGICAL MANUAL FOR PLATON IMPLANT SYSTEM